Tysonwang8251

RESULTS Among 520 patients, 7% achieved 4v-remission and 12% PGA-near-remission. Radiographic progression was observed in 29% of patients in 4v-remission (OR versus non-remission, OR=0.32 [95%CI0.15-0.68]) and in 45% of patients in PGA-near-remission (OR=0.65 [0.38-1.11]); the comparison was not statistically different (OR=0.49 [0.20-1.18]). In 3v-remission it was observed in 39%. Of the individual components, only SJC28 and CRP were associated with radiographic progression. CONCLUSION All definitions of remission led to low structural degradation in EA 4v-remission led to less progression than PGA-near-remission but without a statistically significant difference. Both 4v-remission and 3v-remission appear useful targets when aiming at structural non-progression. This article is protected by copyright. All rights reserved.OBJECTIVE Shared decision making (SDM) is a strongly endorsed approach by which patients and clinicians work together to formulate a sensible care plan. We conducted a systematic review of SDM trials in patients considering knee arthroplasty (KA) to characterize how SDM was supported and the impact on care received. METHODS We searched multiple bibliographic databases from inception to December 31, 2019. A pair of reviewers working independently selected studies for inclusion, extracted data, and evaluated each trial's risk of bias. RESULTS We found 6 eligible randomized trials (4 included KA and hip arthroplasty), all of which tested the same proprietary decision aid (DA) (Treatment Choices for Hip or Knee Osteoarthritis) with some adding other materials to support SDM. These trials, all of which had moderate to high risk of bias, focused on assessing the effect of the DA on patient knowledge about the options, while not explicitly supporting other aspects of SDM such as choice awareness, deliberation, or decision-making. One trial found an increase in the number of African Americans undergoing KA in the 12 months following the intervention. No other trials found that SDMs impact clinical outcomes. CONCLUSIONS Evidence for SDM in patients considering KA is mostly limited to a single DA. While use of this decision aid improves patient knowledge about their treatment options, this tool has not been shown to promote SDM, impact treatment decisions or satisfaction with care. Future work should seek to support SDM directly, and assess effects on treatment decisions, functional outcomes, and satisfaction. This article is protected by copyright. All rights reserved.A low lymphocyte count puts immune-compromised patients at risk of mortality. hIL-7-hyFc is a homodimeric interleukin-7 (IL-7), a potent T-cell amplifier, fused to the hybridizing IgD/IgG4 immunoglobulin domain. We performed a randomized, double-blind, placebo-controlled, dose-escalation, phase 1 study to assess the pharmacokinetic, pharmacodynamic, safety, tolerability and immunogenicity profiles of hIL-7-hyFc administered subcutaneously (SC) and intramuscularly (IM) to healthy volunteers. Thirty subjects randomly received hIL-7-hyFc or its matching placebo in an 82 ratio at 20, 60 μg/kg SC, or 60 μg/kg IM. hIL-7-hyFc was slowly absorbed and its terminal half-life was 63.26 hours after IM administration. hIL-7-hyFc increased absolute lymphocyte count, mostly in T-cells, which peaked 3 weeks after administration and then lasted for several additional weeks. hIL-7-hyFc was well tolerated after a single SC and IM administration. Injection site reaction was the most common treatment-emergent adverse event, which resolved spontaneously without treatment. hIL-7-hyFc can be developed into a beneficial treatment option for patients with compromised T-cell immunity. This trial was registered at www.clinicaltrials.gov as #NCT02860715. This article is protected by copyright. All rights reserved.BACKGROUND Epidemiologic data on obstetric and oncologic complications in twin pregnancies combining a complete hydatidiform mole (CHM) coexisting with a normal fetus and placenta are limited. OBJECTIVES To evaluate perinatal and obstetric outcomes for mother and fetus and risk of gestational trophoblastic neoplasia (GTN) in twin pregnancies including a CHM. SEARCH STRATEGY Pubmed, MEDLINE, and EMBASE and the grey literature were searched for articles published between May 1980 and May 2019 using a protocol designed a priori and registered on PROSPERO (CRD42018112524). SELECTION CRITERIA Observational cohort studies of four or more cases confirmed by histopathology and providing data on pregnancy outcomes and GTN. DATA COLLECTION AND ANALYSIS Two reviewers independently reviewed abstracts and full-text articles. The quality of the studies was assessed with the Newcastle-Ottawa scale and a meta-analysis was performed. MAIN RESULTS Of the 344 abstracts identified, 14 studies (244 cases) met the eligibility criteria. The incidence of maternal complication in ongoing pregnancies was 80.8% and included vaginal bleeding, hyperthyroidism and pre-eclampsia. There were overall 91 (50%) live-births in ongoing pregnancies and 83 (34%) of the total cases were subsequently diagnosed with GTN. Substantial and significant (p less then 0.001) heterogeneity was found for the incidence of pre-eclampsia indicating variability in reporting the incidence of some obstetric complications between studies. CONCLUSIONS Patients diagnosed with a twin pregnancy combining a CHM and an apparently normal fetus have a high risk of perinatal complications, low live birth rates and around a third of them will develop a GTN and should be managed by specialised multidisciplinary teams. This article is protected by copyright. All rights reserved.Cardinium and Wolbachia are maternally inherited bacterial symbionts of arthropods that can manipulate host reproduction by increasing the fitness of infected females. Here, we report that Cardinium and Wolbachia coinfection induced male-killing and cytoplasmic incompatibility (CI) when they coexisted in a cryptic species of whitefly, Bemisia tabaci Asia II7. Cardinium and Wolbachia symbionts were either singly or simultaneously localized in the bacteriocytes placed in the abdomen of B. tabaci nymphs and adults. Cardinium-Wolbachia coinfection induced male-killing and resulted in a higher female sex ratio in the intraspecific amphigenetic progeny of Asia II7 ICWH and ICWL lines; interestingly, male-killing induction was enhanced with increased Cardinium titer. Moreover, single infection of Wolbachia induced partial CI in the Asia II7 IW line and resulted in reduced fecundity, higher embryonic mortality, and lower female sex ratio. The uninfected Asia II7 IU line had significantly higher fecundity, lower embryonic and nymphal mortalities, and a lower level of CI than both the Wolbachia-infected Asia II7 IW line and the Cardinium-Wolbachia-coinfected Asia II7 ICWH line. Our findings indicate that Cardinium-Wolbachia coinfection induced male-killing, which may have had antagonistic effects on Wolbachia-induced CI in the Asia II7 whiteflies. For the first time, our study revealed that B. tabaci Asia II7 reproduction is co-manipulated by Cardinium and Wolbachia endosymbionts. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Cytological analysis is part of the initial etiological evaluation of serous effusions. The newly proposed International System for Reporting Serous Fluid Cytopathology (ISRSFC) aims to standardize reporting. METHODS All pleural and peritoneal effusion samples admitted for cytological analysis at our institution between 2012 and 2016, and pericardial effusion samples admitted between 2008 and 2018, were reviewed and reclassified according to the ISRSFC. Risk of malignancy (ROM) and performance parameters were calculated. RESULTS 1496 pleural effusion samples were reclassified 12(0.8%) non-diagnostic (ND), 944(63.1%) negative for malignancy (NFM), 9(0.6%) atypia of undetermined significance (AUS), 54(3.6%) suspicious of malignancy (SFM) and 477(31.9%) malignant (M). 64 pericardial effusion samples were reclassified 23(35.9%) NFM, 1(1.6%) AUS, 4(6.3%) SFM and 36(56.2%) M. 763 peritoneal effusion samples were reclassified 5(0.7%) ND, 457(59.9%) NFM, 12(1.6%) AUS, 37(4.8%) SFM and 252(33%) M. The ROM was, respectively, for each of the aforementioned categories, 57.1%, 23.9%, 50%, 76.2%, 100% in pleural effusions, 100%, 26.3%, 62.5%, 91.7%, 100% in peritoneal effusions and 0% for NFM, 0% for AUS and 100% for M in pericardial effusions. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were, respectively, 61.6%, 100%, 100%, 73.3%, 81.3% for pleural, 100%, 100%, 100%, 100%, 100% for pericardial and 61.2%, 100%, 100%, 70%, 79.7% for peritoneal effusion samples. CONCLUSION Serous effusion cytology has a high specificity and positive predictive value and a modest sensitivity and negative predictive value, supporting its role in confirming the diagnosis of malignancy. The ISRSFC will increase standardization and reproducibility in reporting, leading to improved clinical decision-making. © 2020 Wiley Periodicals, Inc.OBJECTIVE To appraise the highest available evidence provided by randomised controlled trials (RCT) on the effectiveness of hip arthroscopy vs physical therapy in patients with femoroacetabular impingement syndrome (FAIS). METHODS Four databases (MEDLINE, EMBASE, Web of Science, Scopus) were systematically searched until 1st October 2019. Eligible studies were RCTs in which FAIS patients underwent hip arthroscopy or physical therapy. The study outcome was the International Hip Outcome Tool - 33 Items (iHOT-33) score, a measure of hip pain, function and quality of life, assessed at baseline and at the follow-up closer to 12 months after randomization. The pooled mean difference in iHOT-33 scores within and between the treatment arms was computed using a random effects model. Minimal clinical important difference in the iHOT-33 score was set at 10 points. RESULTS Three RCTs evaluating the iHOT-33 score between six and eight months after the interventions were included. Significant increases in iHOT-33 score were observed from baseline to follow-up for both hip arthroscopy (22.3 points, 95% confidence interval (CI) 17.3 to 27.4) and physical therapy (13.0 points, 95% CI 9.5 to 16.4). Hip arthroscopy demonstrated significantly higher iHOT-33 score at follow-up compared with physical therapy (10.9 points, 95% CI 4.7 to 17.0). CONCLUSION Both hip arthroscopy and physical therapy resulted in statistically and clinically significant short-term improvements in hip pain, function and quality of life in FAIS patients. Hip arthroscopy was statistically superior to physical therapy in improving the outcome at follow-up, even if it may not be detected by patients. This article is protected by copyright. All rights reserved.Pancreatic islet insulin secretion is amplified by both metabolic and receptor-mediated signaling pathways. The incretin-mimetic and DPPIV inhibitor anti-diabetic drugs increase insulin secretion, but in humans this can be variable both in vitro and in vivo. We examined the correlation of GLP-1 induced insulin secretion from human islets with key donor characteristics, glucose-responsiveness, and the ability of glucose to augment exocytosis in β-cells. No clear correlation was observed between several donor or organ processing parameters and the ability of Exendin 4 to enhance insulin secretion. The ability of glucose to facilitate β-cell exocytosis was, however, significantly correlated with responses to Exendin 4. We therefore studied the effect of impaired glucose-dependent amplification of insulin exocytosis on responses to DPPIV inhibition (MK-0626) in vivo using pancreas and β-cell specific sentrin-specific protease-1 (SENP1) mice which exhibit impaired metabolic amplification of insulin exocytosis. this website Glucose tolerance was improved, and plasma insulin was increased, following either acute or 4 week treatment of wild-type (βSENP1+/+ ) mice with MK-0626.